UBC Graduate Research

Delivering a Space for Birth Boni, Chris 2021-05

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“Delivering a Space for Birth”Chris BoniBFA, Nova Scotia College of Art & Design, 2009MFA, York University, 2018Submitted in partial fulfillment of the requirements of the degree of Master of Architecture in the Faculty of Graduate Studies, School of Architecture and Landscape Architecture, Architecture Program Faculty Mentor:  Inge Roecker (GPII)External Mentors:Kim Holden (GPI-GPII)Lisa Sutherland (GPI-GPII)Copyright © May, 2021Delivering a space for birthABSTRACTMidwives provide holistic care to women and partners throughout all the stages of pregnancy and birth. This service should be readily accessible to those living outside of urban centres. Currently in Northern BC, this is not the case for a vast majority of rural and Indigenous women who live remotely. Having to travel thousands of kilometres to access care, and also to merely give birth, this project aims to aid those most in need by offering a basic solution to their birth: a space.iiDelivering a space for birthTable of Contentsii Abstractiv List of Figuresvi Acknowledgementvii Dedication8 The Birthpod: Research, Relevance & Design27 April 26th, Thesis Defence58 Animation Stills I71 Animation Stills II173 Bibliography177 Behind the ScenesiiiDelivering a space for birthLIST OF FIGURES1.  “The Backup Plan” 2010, Directed by Alan Poul, starring Jennifer Lopez.2. Author. Main and Top Floor Plan of our house; at 11:45pm my wife began active labour on the couch in the living room3. Author. Main and Top Floor Plan of our house; 12:45am we moved my wife to the bathtub as the Doula arrived.4. Author. Main and Top Floor Plan of our house; 1:45am the Doula performs reiki on my wife.5. Author. Main and Top Floor Plan of our house; 2:45am my wife’s water breaks while on the toilet6. Author. Main and Top Floor Plan of our house; 3:45 midwife arrives and we move my wife into bedroom upstairs.7. Author. Collage of Midwives throughout History including Ina May Gaskin, Photographer Unknown8. Author. Collage of Film stills from: “Juno” 2007, “Grays Anatomy” 2005-Present, “The Coneheads” 1993,  and “Knocked Up” 2007, 9. Author. Collage of various interior stills of Labour and Delivery Rooms in Canada and the USA10. Author. Collage of various interior stills of birth centres in Canada and the USA11. Ariadne Labs, MASS. Presence of Technology in Hospitals and Birth Centres12.  Ariadne Labs, MASS. Interior Floor Plans of a Birth Centre and two Labour and Delivery Rooms13. Author. Ground Level Plan of Dar a Luz Birth & Health Centre, Albuquerque, NM14. Author Collage of Mindbodyspirit Architecture article by Bianca Lepori, Maralyn Foureur & Carolyn Hastie15. Author. Concept Drawing from Maralyn Foureur article.16. Author. Concept Drawing of various birth-room design elements from Maralyn Foureur article.17. Author. Concept Drawing for decline of maternity services in Northern BC needing aid from the South.ivDelivering a space for birth18. Author. Collage of Jude Kornelsen’s articles on Evacuation Birth and Rural and Remote birth.19. Author. Concept Drawing representing Evacuation Birth.20. Author. Drawing of British Columbia’s 5 health regions.21. Author. Concept Drawing of FNHA locations throughout BC.22. Author. Concept Drawing of FNHA locations throughout BC and the Northern Health Authority.23. Author. Concept Drawing NHA and Hospitals with 3+ rating.24. Author. Concept Drawing of NHA and Hospitals with 3+ rating and UNBC Hospital.25. Author. Concept Drawing of NHA, Hospitals & Language Barrier’s for First Nations in BC.26. Author. Concept Drawing of NHA, Hospitals and routes for evacuation births.27. Author. Concept Drawing of NHA, Midwives throughout health region.28. Author. Concept Drawing of NHA, Indigenous territories throughout health region.29. Author. Concept Drawing of Pacific Northwest Coast Plankhouses, reference drawings taken from “Native American Architecture” by Peter Nabokov and Robert Easton.30. Author. Sketchbook drawings for exterior form.31. Author. Sketchbook drawings for interior birthpod.32. Author. Concept Drawing of Hospital + Home = Birthpod33. Author. Concept Drawing of Semi-truck for Birthpod shipping34. Author. Concept Drawing of Semi-truck dimensions for Birthpod shipping35. Author. Concept Drawing of locations for Birthpods throughout  NHA based on 1 hr driving radius36. Author. Concept Drawing of 2.3 Vancouver Specials = 20 Birthpods in cost, which is $175,000 per pod.37.  Author. Stop Motion Animation of Birthpod being dropped off at a site.38. Author. “Delivering a Space for Birth” Stop Motion Animation frames39. Author. Photo behind the scenes of “Delivering a Space for Birth”vDelivering a space for birthAcknowledgementI would firstly like to acknowledge the consistent aid and detail at which my father, Anthony Boni, shared his well of knowledge and talent with me regarding building in the North, as well as pre-fabricated, modular construction, and many other concepts and ideas regarding the Birthpods. Secondly, I would like to thank my wife, Britt Irvin, for the continued and endless love, care, and inspiration she fuels in me on a daily basis. Thank you for trusting me and feeling comfortable marrying a student. Thank you for having the power and determination to coordinate a successful home-birth which inherently planted the seed of this entire thesis. I am grateful to Kim Holden who chose to battle her own journey as a birthworker, and laid the groundwork of inspiration for me to reach out to her, inspired purely by her personal story, and to have accepted this project whole-heartedly at its most infantile stage. I am thankful to Lisa Sutherland for taking on the role of mentor and engaging in our dialogues about architecture and design with professional tact and brilliance. Your keen and assertive diligence towards the roles of midwives was instrumental when considering the spaces in which they are to work and move within. I would like to send a shout-out to the Skeena Midwives who responded honestly and directly to the initial concepts I shared, and have since been ever-so vocal in your desires for the Birthpod and its potential realization. I would like to also thank Raman & Sommer for being the best birth-coaches and stewards anyone could have asked for. I would like to deeply thank Inge Roecker for accepting to work on this project, with her personal work experience in the North and the many entertaining conversations, it was a pleasure having you join this team.Finally, I would like to commend all the midwives, doulas and practicing healthcare workers throughout BC, Canada, and the World that attempt to bring a sense of safety, security, and empowerment to the birth room.viDelivering a space for birthDEDICATIONThis project is dedicated to Britt & Véa, the two most important elements in the pod.vii8 Delivering a space for birth[I]n these spheroid egg-shaped structures, a human being can now take shelter and live as in his mother’s womb.1 Thou hast not yet turned the full circle through;So why put on such a bewildered airIf now and then we come upon something new?2I OFTEN SUGGEST TO PREGNANT WOMEN THAT THEY IMAGINE THEMSELVES TO BE A LARGE MAMMAL WHEN THEY ARE IN LABOR. MANY SAY IT HELPS THEM TO FIND THE WILD WOMAN WITHIN AND TO TAP INTO THE ANCIENT KNOWLEDGE THAT IS THE POTENTIAL OF ALL WOMEN3THE BIRTHPOD: RESEARCH, RELEVANCE & DESIGN   This thesis grew out of the origins of life, that being the birth of our daughter on March 9th 2020. Under the guidance and assuredness of my wife, we had a home birth. Hiring a local doula and midwife, we prepared for an even that promoted itself as having a million variable outcomes. With endless advice and available material on how the prepare, the event itself is completely spontaneous. One has to be inventive and confident. Our birth went flawlessly, however we also didn’t do anything we thought we would. Scrambling around to find soothing lighting (the himalayan salt lamp from the bedroom), and feverishly scanning YouTube for a background music track (an 8hr OM mantra chant), the birth seemed hectic and scattered until the birth works arrived. Raman, our doula, quickly took my wife to the lounge chair and quickly began to begin reiki. When our midwife arrived we transitioned my wife to our upstairs bed where our daughter was quick to exit her private home.    Birth equals choice. A birther during the perinatal phase intuitively or clinically makes the choice of what medical professional will support them alongside their birth process. Whether to have a home birth or a hospital birth is not always 9 Delivering a space for birtha straight forward question, and can always change prior (or during) birth, yet the one does need to build their health care team relatively early on, as it becomes a high priority within any community and waitlists become a real thing. If having a home birth, a midwife is required (a second one shows up just for the birth) and a doula is a personal option, not required but highly suggested. A doula is financed privately while a midwife works for the Health Authority. If having a hospital birth an Obstetrician or OB is required, and a meeting is firstly organized with the desired hospital. The OB that one meets is not necessarily who will be present during the birth, and one cannot be sure to have a male or female.4  Understanding the relative safety of primary maternity services when compared to services that offer local cesarean section is instrumental when integrating the option of a home or hospital birth. Both funded by the Canadian Health Care System, one chooses early on in their pregnancy whether to begin seeing a midwife or an OB. Choosing a midwife offers a more holistic approach offering the chance to have the birth that they want. Though this drawing promotes the OB somewhat as a villain, it is important to note that obstetric care is fundamentally a settler colonial tradition and a symbol of Westernization for medical – and especially – perinatal care.5 Midwifery has been around centuries longer than obstetric care (there is no official date when women began aiding the same-sex through birth) but in the 1700’s in Quebec, it was noted that even Priests weren’t allowed in the birth room during a pregnancy.6   After my wife and I’s life-altering experience, I began to contemplate with her  the appropriate space available for midwife-led births. Currently in Vancouver there are no “birth centres”. As is stated on the Ontario Midwives website, a birth centre provides “family-centred, culturally safe spaces for 10 Delivering a space for birtheveryone who uses them. They specifically aim to be inclusive to communities that have historically faced marginalization (e.g. Canada’s Indigenous peoples, 2SLGBTQI+ people, newcomers to Canada, and members of linguistic, cultural and/or racialized minority communities).”7 As can be gained from this brief synopsis, before even explaining the physical, medical and design-oriented elements of a birth centre versus that of a traditional L&D room (Labour & Delivery) in a hospital, it begins with the psycho-social aspects of its space. Thus, the space of a birth centre hones in on the arena of inclusiveness towards birth. This inclusiveness happens two-fold, both on the birther as well as the birth worker. As the birther is equally accepting the inclusiveness of the midwife as a professional healthcare practitioner (of which they must obtain a professional degree equal to that of a nurse) and the midwife of the birther as an equal participant in the journey of life with them. Racism is at the root of public healthcare within Canada, especially in the Northern provinces and regions.8 With not only birthers, but birth-workers (midwives with decades of work experience) having to step down from their professional roles due to the mistreatment from other professional healthcare practitioners. Most recently, two Inuit midwives resigned from their positions working over 2 decades in Nunavut.9 What is shocking in this specific context is that it was actually the Department of Health in Canada that mistreated these women, and not co-workers. Beginning to see the severe and traumatic aspects of this most-nurturing of professions, I began cold-calling midwives within BC. After talking to numerous women working in most of the 5 health regions, I eventually was guided towards Jude Kornelsen’s writing and reports. I was able to speak to her as well, and attempted to begin to understand the mandate in the Northern Health Authority (NHA) for evacuation births, 11 Delivering a space for birthcomprising two-thirds the geography of British Columbia, dominated by rural and remote communities.10   Canada is both organically and systematically cut into 10 Provinces, with health care separated provincially, organized in a centralized system split into regions that are each in-themselves self-defined.11 Each region thus works independently with Provincial aid to organize and fund specific demands. British Columbia, a vast 100 million hectares where the savagely voluminous Rocky Mountains snake south-east from, create some of the most dangerous and scenic highways in the world. Conflations of tree species from spruce, pine, fir, cedar and hemlock intermingle and dance through endless vistas, hillsides, crags and peaks. BC is grand in stature and rich in landscape, being home to Indigenous peoples for over 10,000 years, who’ve established a heritage in the Pacific North West which we are continually working to rebuild and acknowledge.12 BC is thus split into 5 Health Authorities that attempt to separate themselves somewhat through a geographical lens. The First Nations Health Authority spreads from top to bottom of BC. They state that they have began “a new era in BC First Nations health governance and health care delivery”13 by taking over services previously in control by Health Canada, thus transforming the way health care will be delivered to BC First Nations.The FNHA provides community-based services across all disciplines of health. They also provide access to a full range of maternity services for First Nations and Indigenous women. Equally, they advise and aid in bringing birth closer to home and back into the community by creating inclusive, midwifery-led programs, prenatal nutrition programs and outreach. With more than 130 medical health centres and nursing stations throughout BC, FNHA supports: 12 Delivering a space for birthFirst Nations and Indigenous children, youth and maternal health, mental health and wellness, e-health and telehealth, environmental health and research as well as establishing a health infrastructure and human resource centre, all accessible online.14   Hospitals rated Level 3 Care or higher can support cesarean sections. Throughout British Columbia there are 51 Hospitals that support cesarean surgery, and have been given a hospital rating of Level 3 or higher. This means that these hospitals are registered to conduct a surgery which the Health Authority deems as being the safest place possible for birth. With only 7 Hospitals located across the NHA region that can perform cesarean births, women who live outside of the few major cities must evacuate to the nearest hospital where there is a physician to perform (if applicable) cesarean section.15  This is a mandate put into effect no matter how healthy  the birther may be due to prior checkups and tests. Coined an evacuation birth, where the birther travels alone or with a family member(s) from their home to a city which has a hospital level 3+ or above, is enlisted when the birther is 36 weeks pregnant.  An Evacuation Birth is also referred to as a maternal medical relocation model. In rural BC 40% of women must travel more than one hour for general healthcare maternity services (2% for women in urban settings).16 As a proposal to solve this problem of rural distance and care, BC has established a mandate for birthers who live in rural communities to travel, at their own expense, to the nearest hospital that supports cesarean care. The outcomes of this dilemma are tenfold. Neonatal morbidity is severely impacted by travelling yet some solutions could integrate inter-facility transport services on a closer, more synchronized communication platform although the problem still stands – is 13 Delivering a space for birthit safer to evacuate from your community rather than support a midwife-led birth?17The studies show a clear benefit of local maternity services for birthers and the health system. “Women from communities with any form of maternity care showed lower rates of prematurity, lower rates of admission to high acuity NICU’s and shorter stays while in high acuity NICU’s”.18 The only NICU within the NHA is in Prince George.    As is understood geographically, evacuation births remain the dominant approach towards First Nation women in remote communities, whose culture of birth integrates generations of family members to be present during a birth. “Aboriginal women are suffering from the lack of equitable access to culturally appropriate midwifery, and this is resulting in higher risks of adverse pregnancy and poorer infant health outcomes when compared to the general Canadian population.”19 Such a procedure as an Evacuation Birth means that patients incur significant out-of-pocket costs on travel, accommodation & hospitality. These costs on-average equal to $2,235 per person.20   Beyond the monetary scope, one has to consider the psychosocial, physical, and personal stress impacts of travel before and after labour.21 Leaving ones community at 37 weeks pregnant to travel hours away in inclement weather would be inherently severely stress inducing, a symptom that can delay dilation, cause preterm birth and low birth weight.22 Likewise, the preparation of ones trip throughout the pregnancy and leading up to departure is truly beyond conception. Not knowing where one may be staying, what the room will be like, who will be able to be there with them and/or undergoing this process alone are just some of the few stresses that can occur from Evacuation Births.14 Delivering a space for birth   Since 2000, BC’s maternity care services have been in severe decline, with 20 rural centres having closed due to regionalization, which provides un-specific treatment and un-inclusive decision making instead of case-by-case solutions for health care.23 As a mandate to concentrate the dominant Health Authorities into 5 regions, B.C. allowed for outlying, rural communities to lose their maternity services in order to focus the specialized labour in larger cities. This is the broader outlook as to why patients have to evacuate to these cities to obtain the care they need while not being supported for the adverse costs this type of process would incur. Regionalization has made it even-more difficult to request and obtain sufficient treatment for birth support, thus midwife-led services offer a safe possibility for low risk, natural births. On a positive note, 5 communities offer healthy, local maternity services that are 100% midwife-led. Meaning that they operate on the knowledge and fact that there is no hospital that supports surgery within an hours drive or travel, proving it’s possible to sustain healthy births without access to surgeons!   All of these first hand dialogues with various individuals both professional and local as well as the thorough research I conducted in the areas of midwifery care and birth centre/hospital design, compelled me to begin resolving the issue at-large. That integral decision, to solve is often said by architects as a means to complete a project or program in the best way possible. Due to the highly politicized content I was attempting to juggle, the verb ‘to solve’ seemed like a far cry from the reality of life for birthing and pregnant women in Northern BC; however, the intent ‘to solve’ definitely reverberated in my thesis design of the Birthpods. At a theoretical level, the Birthpod is a design formula that takes 15 Delivering a space for birthroot in the act, motion, and origin of the birthing process from pre to post-natal experience, facilitated by a midwife. The Birthpods stem from the desire to bring aid to a vast geographic region as efficiently as possible. Thus, the design - made in a contemporary modular fashion within a hermetic factory using CNC and CLT building components and devices - would be able to be assembled easily by unskilled craftsmen in regions of Northern BC where climate and location make it difficult to build. Having the unit nearly 95% pre-fabricated, the design can be deployed in a manner that is just like shipping anything to the north – strapped down to the back of a flat-bed semi truck. Distributed to communities that can obtain two practicing midwives, the Birthpod can become an integrative beacon of health and wellness within the community. Succinctly merging the personalized care which midwives offer, with the sense of safety and professionalism that most birthers feel they want from the concept of a hospital. The Birthpod is a step towards facilitating those that have been stripped from their basic rights as human beings, and equally as Canadians. The right to birth should not be a privilege, and the communities that populate Northern BC deserve that this issue be addressed, answered, and implemented.•   What has currently been left out of this discourse is the relevant research garnered from the conversation, readings, and interpretations of space that I was consistently wading through. How could we merge the foundation of life: that being the primal act of bringing life into a space, as architecture. Juhani Pallasmaa has dove into these merky and transcendent waters in a consistent tussle with the deviant 16 Delivering a space for birthand ever-present sensatory realm of space – experienced , interpreted, and unconsciously experienced through the senses of our body.24 Pallasmaa endeavours to promote the vehicle of architecture as something other than the Kantian object which is “dependent on the conception of an end”,25 but as a place that is “encountered; it is approached, confronted, related to one’s body, moved through, utilized as a condition for other things. Architecture initiates, directs and organizes behavior and movement. A building is not an end in itself; it frames, articulates, structures, gives significance, relates separates and unites, facilitates and prohibits.”26 These descriptive tools mark the object of architecture as an object that promotes interpretation and experience byway of its suggestive and open nature – something that exists  without an end, but as a lived routine. When contemplating and embracing the idea of a space honed to the potential for promoting a multitude of acts (and facilitating a major climax in life such as that of birth) the design process had to stay open, engaging in readings that were sourced in the content and nature of the experience of birth, as well as a self-guided, metonymic effort to find new sources, re-kindle old references, embrace the unexpected and forego what was already known about space-making. Did the relatedness of this structure need to respond back  to the user?    Sylvia Lavin delves into the matter of a “kissable” architectural experience, or rather an object that can utilize affect rather than effect.27 Lavin promotes the move away from static “facadism” and attempts to embrace “qualities more generally associated with other mediums, from luminescence to colorfulness and from slow opacity to quick and animated pattern.”28 Even though these examples hint at a large example of contemporary design strategies, they 17 Delivering a space for birthdo help in moving the material forward  in experiential time, rather than backwards, to the stoic and grand gesture that marked most city-states as the dominance and power of God. Using an example of artist Doug Aitken’s collaboration for a house in Dutchess County, wherein the entire façade and perimeter site walls were designed to be projected onto at night. She states that “the moment the house becomes “real” it will become lost in the virtuality of its envelope, with every built surface veiled in a projected image.”29 This play with 2d, that of projected image, isn’t something new at all. Film has had over a century of invigorating experimentation and deployment as a public medium. What I found interesting was that another key influence in my design process, Australian professor of midwifery Maralyn Foureur, began promoting interior projects within birth-spaces over a decade ago.30 Her studies were not just fleeting attempts to see what looked interesting and engaging from her vantage as a birthworker and researcher, but actually conducted live-studies with women who birthed in rooms (within hospitals) that were cleared out and outfitted with 4 projectors that shone images of forests and water during the labour and birthing stages on the surrounding walls. Unfortunately, after conducting a randomized study which included 680 women that had never had a birth before, they did not find that “giving birth in a specifically designed birth environment room lowered the use of augmentation during labour.”31 Strangely, a Canadian study in 2009 which included 62 first-time birthers found that fewer women “needed oxytocin (induced) during labour in a so-called ‘ambient birth room’ (40% versus 68%)”.32 Though this study goes against Foureur’s findings, I almost wanted to suggest that the design of her birth-room that focused on specialized birthing experience actually referenced, in visual concept and identity, that of the white cube. Coined 18 Delivering a space for birthby architectural critique and historian Brian O’Doherty in the 70’s, he labelled the white cube as an architectural ambition of the highest order, “modernism’s triumphs – a development commercial, esthetic, and technological. In an extraordinary strip-tease, the art within bares itself more and more, until it presents formalist end products and bits of reality from outside, - “collaging” the gallery space. The wall’s content becomes richer and richer (maybe a collector could buy an “empty” gallery space).”33 Taking this developmental process of contemporary art’s suggestive economic and transcendent nature as a space to bring birthers into may have inadvertently caused an internal reflex to snap back within her subjects, as no one likes being watched, and to even quote earlier writings by Foureur herself, “In the hospital we (midwives and women) found ourselves limited and constrained by the lack of privacy.”34  Not to dwell on Foureur’s fascination with projection as a means for better enclosure, and/or comparing that space to the ever-observant and ‘aware’ realm of a gallery space, but seeing that gesture as an attempt for making an already sterile space more liveable, flexible and “un-bounded” – to use her terminology.    As the Birthpod design development moved along, I needed to interrogate the role of accessible design within the space. This feature – a task that would make the unit stand-alone from current ‘tiny-homes’ and other anti-conformist modes of habitat that linked nomadic travel and home, was used as a guide-post to spatialize the small and intimate interior which landed around 500 sqft of usable interior floor area. Take an everyday example of accessible design which resides within the city-street, something as obvious and currently taken-for granted as curb-cuts. Unbeknownst to most, disabled people had publicly called for their implementation since 19 Delivering a space for birth    the 1940’s.35 When non-disabled people use designed and accessible space they quickly and intuitively accept its mode of operation as “what exists” and usually, that design decision makes movement efficient for all persons. It may seem absurd to most citizens that the Disabilities Act of 1990 mandated curb cuts at all street corners, 50 years after beginning to raise the issue of mobile inefficiency and inherently a space supposedly within the public sphere. This approach, attempting to create accessible design which seemed to fit into the inherent design language of the project, was taken up through various kinetic choices. I took extra effort to create flip-down tables that minimize ground coverage and can be pushed up when not in use, pocket interior and exterior doors for simple closure and openness as well as pocket-shutters on tall windows, an accessible washroom that invites the ADA 5’ diameter of movability, and a murphy bed which when locked in an upright position opens up the birthing-area significantly. Though some elements, like the murphy bed, could be designed to operate single-handedly, the truth is that all persons laboring would be serviced by one or two health professionals/midwives. As a birthing woman could need physical assistance at any point they desire, the knowledge that a birthworker would be in the room with them to assist was made even more fluid by encompassing simple intercoms from the birth area to the front living room/midwife space.   The Birthpod is an experiment in embodied architecture. Pallasmaa uses this term in endearing ways, and so do other writers that attempt to make the literal sense of embodiment the sole protagonist within design. Splayed out quite literally, Mark L. Jonson states that “[h]uman beings are creatures of the flesh who arrange spaces and physical structures fitted 20 Delivering a space for birth    to their bodies.”36 He goes on to orient architecture and the internal makeup of human beings inherent drive to form and build specific and particular spaces as “simultaneously our need for physical habitation and our need for meaning.”37 When visiting Cappadocia in Turkey, years before I began to study architecture, I was struck – as most tourists are – by the sensational dwellings that were carved out of the volcanic landscape, the “fairy chimneys, or hoodoos”38 interpret the aesthetic of inhabited space like we one day may do on other planets. That is, utilizing the full nature of deposited and eroded existing structures as the sole material that we inhabit. Not only were a plethora of built-in’s organically carved into the dug-out dwellings, but frescoes and wall-adornment was present on the interior surfaces from centuries of various peoples living within them. This self-adornment and inherent need to make a space feel like ones-own, or apply a subjective touch within a space to feel comfortable, was taken towards the interior design decisions within the Birthpod. Utilizing a specific “homogenous tackable surface material made primarily of natural materials including linseed oil, cork, rosin binders and dry pigments mixed and calendared onto a natural jute backing”39 that is washable, reduces light relfection, is anti-static, thermal conductive, flexible, and resistant to bacteria was essential when preparing the interior surface of the Birthpod. The reference to Cappadocia recalls the need to alter, shift, and apply the hand to the space; thus, this wall covering offered the permeable capability to add art, photos, fabrics, etcetera to its surface in an efficient and un-harmful way that would normally deteriorate other materials. This act, to make ones space personal  is a feature of the design that I would like to explore further, ways in which varied personal space-making can be instilled within the pre-fabricated module 21 Delivering a space for birthand  engaged in the materials chosen or options placed within and around the space. Designing for potential uses is a design formula that can come out of design processes that are interrogated when applying accessibility to spaces, making them multi-functional and unanimously usable in both predictable and unpredictable ways.    Another source that spoke out to me throughout this process was Sarah Robinson, an architect from the Bay Area who has co-published with Pallasmaa. Her book “Nesting: body dwelling mind” is an exceptional source for incorporating that practice of honing design towards the manifested makeup of our origins and nature. In describing the shift in light from day to night she explains: “the transition is certain, the daily shift from dark to light announced by a band of blue, the moment of tranquility, when the silence of night is thrilled by life awakened. This is the ‘blue hour’ between darkness and daylight when flowers are at their most fragrant and when creatures rustle, fly up, and trade places.”40 To bring forth the sleep-cycles of species other than the human, such as the bird, the bug, the mammal, is intrinsic to our understanding of time, space, and those that we share it with. A Mammals circadian rhythm is based on the rise and fall of the sun, the moon, planetary constellations that shift our oceans and fuel our days. This relationship with light, a long-exchange that architects like Steven Holl, Louis Kahn and Frederick Kiesler built a distinct practice out of, was instrumental when shaping the interior beams within the birth area of the Birthpod. By creating a clerestory system that is aided by a semi-translucent material which hugs the interior ‘curves’ of the interior, light can be cast and refracted downwards promoting a softened, comforting glow. As night approaches, interior LED lighting systems can be managed 22 Delivering a space for birthto accent and symbolize space through the use of diffuse colour. It has become ever-more common to use LED’s as general hardware within homes to have the personalized option to select and emit various hues of the colour spectrum. During a retrospective of Olafur Eliason’s work at the Martin-Gropius-Bau in Berlin, his team created a space where colour was quite literally embodied. 41 Built of simple LED tubes hung across a vast low-ceilinged space, the emitted colours shifted throughout the spectrum of a rainbow (ROYGBIV) in real-time. Yet, as one walked through the massive interior, a fog machine continually filled all surrounding space, so-much-so that you could barely see your hand in front of you, and thus the space was full of colour, slowly transitioning every few metres. One would walk from Red, become Red, then transition to Orange, become Orange, and so on until the piece was over and you exited. It was overwhelming and absolute, it was one of the most pure examples of colour-experience I had ever been a part of. Not saying that I would want to integrate a completely immersive experience for a birther that would take them out of their body and into the lived-body of a colour emitted around them, but that I would be interested in seeing how much colour could create affect within the birth experience and room   To double-back on the intricacies of space and how our own subjective desires can perhaps benefit and aid the personalized experience and hospitality of it, Moshe Safdie came out with the seminal essay on Form & Purpose in which the ruse of reactive design was based out of a sole pursuit of reason and necessity. As is clearly stated, “[t]he richer the environment and the more fulfilling it is, the less dependent we are on artificial ways of improving it.”42 In a more critical context (which is the primary tone of this essay), Safdie puts 23 Delivering a space for birthdown post-modernism as ‘dated’ buildings because they display how “shallow, how unintegrated into the environment they are. We also see the individual architect trying to identify himself by his own personal style. In most cases the identifiable style is just a visual gimmick, something tacked on for identification.”43 What must be taken from these critical and personalized  critiques of architectures most subjective eras, is that design decisions are what we can indeed critique. Decisions that makeup the confluence of terminology, idioms and realities of our history. That is because design was always striving to be other  than some inert force, it strove to become the emblem of power, diplomacy, and autograph of a ruler and established hierarchy. To take from these deeply pervasive elements in humanities past is difficult and complicated, yet by searching for a way to integrate a built, designed, and conceived decision into its surroundings is the way in which a structure (however inhabited) may best benefit from living an effortless life beyond the wake of criticism and function.    To end with James Corner, a landscape architect who has underlined the necessity for  the landscape architect within the broader conversation within academia and practice, relishes in the ways in which a design can profit from evolving out-of  the act of mapping. Mapping, he states, “is never neutral, passive or without consequence; on the contrary, mapping is perhaps the most formative and creative act of any design process, first disclosing and then staging the conditions for the emergence of new realities.”44 Looking back to a collaborator of Foureur, Bianca Lapori, who mapped birthers within their own habitats and homes in cosmopolitan Italy,45 and how the future mapping of the Birthpods would have to be configured to benefit adjacent communities, 24 Delivering a space for birthlocating them within, beside, and amongst key-clusters throughout Northern BC, adds a formative and potentially dynamic and expressive design-shift to the Birthpod. Early on my research swept me across the Province where I was born in, to regions that I’ve seen only on Google map, and observed the ways in which habitat and home are accessible solely by un-paved gravel roadways which mitigate and traverse extremely hazardous and unlivable areas of landscape. Northern BC projects itself as the ultimate agency of refuge, where the deep shadows of the Rocky Mountains create dynamic spatial divides and impossible access. Having facilities taken away from an already limited source-pool is the traumatizing factor that engaged my studies into these issues, only to have them widened and gauged out when I learnt more about evacuation births. I hope that this study and proposition can influence future students and architects to traverse territories of study that revolve in the real-world. Not to say that fictitious and conceptual problems don’t aid the future of design and our process of investigation, but that there are so many holes in our world, with aspects of inequality blinding those that cut them. A role that an architect can forcibly construct is the bridge of communication between all levels of stakeholders, enticing a new language of design out of the conversation.25 Delivering a space for birthENDNOTES1 Dalibor Vesely, ‘Surrealism and Architecture’, Architectural Design, 48, 1978, 94 (p. 1).2  Dorothy L. Sayers Dante Alighieri, The Divine Comedy: Hell (Penguin Classics, 1950), i, p. 159.3  Ina May Gaskin, Ina May’s Guide to Childbirth (New York: Bantam Books, 2003), p. 279.4  ‘Midwife, Family Doctor or Obstetrician: Who Should Handle My Prenatal Care?’ <https://www.theglobeandmail.com/life/health-and-fitness/ask-a-health-expert/midwife-family-doctor-or-obstetrician-who-should-handle-my-prenatal-care/article13857840/> [accessed 17 December 2020].5  Samuel S. Thomas, ‘Early Modern Midwifery: Splitting the Profession, Connecting the History’, Journal of Social History, Oxford University Press, 43.1 (2009), 115–38 (p. 8).6  Susan McNelley, ‘Hélene’s World: Hélene Desportes of Seventeenth-Century Québec’, American-Canadian Genealogist, Our Family History, 40.140 (2014), p. 3.7  ‘Why Give Birth at a Birth Centre? | AOM’ <https://www.ontariomidwives.ca/why-give-birth-birth-centre> [accessed 30 April 2021].8  ‘Inuit Midwives Say They Left after Experiencing Years of Mistreatment | National Post’ <https://nationalpost.com/pmn/news-pmn/canada-news-pmn/inuit-midwives-say-they-left-after-experiencing-years-of-mistreatment> [accessed 30 April 2021].9  (Ibid.)10  Northern Health, Northern Health Service Plan, 2020 2017.11  Kornelsen, Jude, McCartney, Kevin, and Williams, Kim, ‘Centralized or Decentralized Perinatal Surgical Care for Rural Women: A Realist Review of the Evidence on Safety’, BMC Health Services Research, 2016.12  ‘WelcomeBC - BC First Nations & Indigenous People - WelcomeBC’ <https://www.welcomebc.ca/Choose-B-C/Explore-British-Columbia/B-C-First-Nations-Indigenous-People> [accessed 16 December 2020].13  ‘FNHA Overview’ <https://www.fnha.ca/about/fnha-overview> [accessed 17 December 2020].14  ‘FNHA Overview’ <https://www.fnha.ca/about/fnha-overview> [accessed 20 December 2020].15  Kornelsen, Jude, McCartney, Kevin, and Williams, Kim., P. 10.16  Kornelsen, Jude, Iglesias, Stuart, and Woollard, Robert, ‘Sustaining Rural Maternity and Surgical Care’, Canadian Family Physician, 62.January (2016). 17  Centre for Rural Health Research, Out-of-Pocket Costs for Rural Residents When Traveling for Health Care: Results from a Province-Wide Survey in British Columbia (UBC).18  (Ibid.)19  NACM, ‘The Landscape of Midwifery Care For Aboriginal Communities In Canada: A Discussion Paper to Support Culturally Safe Midwifery Services for Aboriginal Families’, 2016, p. 3.20  Centre for Rural Health Research, p. 6.21  Kornelsen, Jude, Stoll, Kathrin, and Grzybowski, Stefan, ‘Distance Matters: A Population Based Study Examining Access to Maternity Services for Rural Women’, BMC Health Services Research, 2011, p. 12.22  Calvin Hobel and Jennifer Culhane, ‘Role of Psychosocial 26 Delivering a space for birthand Nutritional Stress on Poor Pregnancy Outcome’, The Journal of Nutrition, 133.5 (2003), 7109S-1717S (p. 2).23 Annette Browne, ‘Issues Affecting Access to Health Services in Northern, Rural and Remote Regions of Canada’, Northern Article Series, 2014, p. 2. 24  Juhani Pallasmaa, The Eyes of the Skin: Architecture and the Senses (UK: John Wiley and Sons Ltd, 2012), p. 69.25  James Creed Meredith Immanuel Kant, The Critique of Judgement (Oxford: Clarendon Press, 1928), p. 365.26  Juhani Pallasmaa, p. 68.27  Sylvia Lavin, Kissing Architecture (New York: Princeton University Press, 2011), p. 101.28  (Ibid.)29  (Ibid.), p. 40.30  Maralyn Jean Foureur, Calida Bowden, and Athena Sheehan, ‘Birth Room Images: What They Tell Us about Childbirth. A Discourse Analysis of Birth Rooms in Developed Countries’, Midwifery, 2016.31  Maralyn Jean Foureur and others, ‘Does Giving Birth in a “Birth Environment Room” versus a Standard Birth Room Lower Augmentation of Labor? - Results Froma  Randomized Controlled Trial’, European Journal of Obstectrics & Gynecology and Reproductive Biology, 2021, 1–7 (p. 4).32  (Ibid.)33  Brian O’Doherty, Inside the White Cube; The Ideology of the Gallery Space (San Francisco: The Lapsis Press, 1976), p. 79.34  Maralyn Jean Foureur, Carolyn Ruth Hastle, and Bianca Lepori, ‘Mindbodyspirit Architecture: Creating Birth Space’, Chapter, 2008, 95–111 (p. 102).35  Sara Hendren, What Can a Body Do? (Riverhead Books, 2020), p. 149.36  edited by Sarah Robinson and Juhani Pallasmaa, Mind in Architecture: Neuroscience, Embodiment, and the Future of Design (Cambridge: The MIT Press, 2015), p. 33.37  (Ibid.)38  silva, ‘Göreme National Park and the Rock Sites of Cappadocia’, Free Photos - Photos777.Net, 2019 <https://photos777.net/photo/g%C3%B6reme-national-park-and-rock-sites-cappadocia> [accessed 1 May 2021].39  ‘Bulletin Board’ <https://www.forbo.com/flooring/en-ca/products/surface-solutions/bulletin-board/btht1n> [accessed 1 May 2021].40  Sarah Robinson, Nesting: Dwelling, Body, Mind (California: William Stout Publishers, 2011), p. 81.41  ‘Innen Stadt Außen • Exhibition • Studio Olafur Eliasson’ <https://olafureliasson.net/archive/exhibition/EXH101165/innen-stadt-aussen> [accessed 1 May 2021].42  Moshe Safdie, Form and Purpose (Boston: Houghton Mifflin Company, 1982), p. 89.43  (Ibid.), p. 91.44  James Corner, The Landscape Imagination, Collected Essays of James Corner 1990-2010 (New YOrk: Princeton Architectural Press, 2014), p. 200.45  Bianca Lepori, ‘Freedom of Movement in Birth Places’, Children’s Environments, 11.Environments of Birth and Infancy (1994), 81–87 (p. 84).27 Delivering a space for birthAPRIL 26TH, THESIS DEFENCEThe following pages contain identical slides to my thesis de-fence, as well as the script I attempted to follow, after which are stills from my stop motion animation films representing the design conclusions for my thesis.28 Delivering a space for birthLand AcknowledgementI acknowledge that I live, play and work on the unceded territories of the Musqueam, Squamish, and Tsleil-Waututh Nations.29 Delivering a space for birth“The Backup Plan”Under my wife’s leadership, we felt safe, secure and proud to have the op-portunity of choice for our birth. That choice lead ourselves to hiring a Doula, Raman, and a Midwife, Sumer, who was also a good friend. On March 8th, on the cusp of Covid becoming a reality in Canada, my wife went into labour.[Fig.1]30 Delivering a space for birth[Fig.4][Fig.3][Fig.2]31 Delivering a space for birthHOME BIRTH MARCH 9, 2020These drawings so the plan of our main and top floor in our house. After the successful birth I began to think of a space that could best be suited for the act, impression, and event of birth.[Fig.5][Fig.6]32 Delivering a space for birthMIDWIVESThe option to have a midwife has come in and out of fashion in the past cen-tury. The story of midwifery involves a mountainous rise of female empower-ment, authority, perspective, and influence followed by having all those things ripped away and at-times, deemed illegal.  From male priests not even being allowed into a labouring room in the 19th century, to a surge 4000 employed lay-midwives in rural Alabama in the 1920’s, to currently around 7000 in all of the USA…from being virtually outcasted from western medical practice at large, to then bounce back and be “legalized”. Their journey has been tough, deserving accountability and promotion. Regulated and publically funded in 1998 here in British Columbia, the story itself is astonishing. Yet throughout the practice, there is a true element of calmness, clarity, and pure intrinsic understanding within the practice.[Fig.7]33 Delivering a space for birthHELLSo in wanting to question the space that occupies birth, I started with the spaces which we  “know” because they’ve been portrayed to us in popular media. These stills were found in familiar films & TV shows that all involve high octane doses of adrenaline during labour. Adrenaline is known to slow down and stall labour, while on the flipside, oxytosin is clinally proven to enhance labour, secreted throughout the bloodstream based on the electrical activity of neurons – thus it is released when these cells get stimultad and excited.[Fig.8]34 Delivering a space for birthHOSPITAL ROOMSThese spaces – though they of course inform empowerment as all birth is –often reduce the secretion of oxytosin, stalling birth, and thus engaging with various drugs to enduce labor.BIRTH CENTRESNotice the oxytosin releasing as you see these images….jokingBut there is a consciousness that begins to be recognized  inside birth spac-es, particularly, birth centres. Places sanctioned and operated by midwives.[Fig.9][Fig.10]35 Delivering a space for birthPRESENCE OF TECHNOLOGYOne main difference is the presence of technology within birth space. Anything hospital related can be seen as involving an ‘emergency’ and this is what can be so stalling psychologically and chemically. Thus hiding and masking the tools used and needed is already a sure-bet when considering the interior design of the Birthpod.[Fig.11]36 Delivering a space for birthROOM STANDARDIZATIONThese plans offer a glimpse into 3 formulas for labour and delivery rooms. The far Left is an example of a birth centre’s unique interior, while the other two show hospital room, outfitted to best serve the health practitioner rather than the birther.[Fig.12]37 Delivering a space for birthAlbuquerque Midwifery ClinincThis is my favourite birthcentre I found which is located within Albuquerque, New Mexico on an acre of land. Designed almost like a small bungalow single family house, the interior feels warm and comforting with the larger rooms reserved for family and friends.[Fig.13]38 Delivering a space for birthMARALYN FOURERA professor of Midwifery in Australia, Maralyn Fourer has published greatly on delivery room improvements and birth space within both private, intimate settings as well as hospitals. By interviewing birthers and looking at current labour and delivery rooms, as well as mapping the routes taken by women when having at-home births, she combined these real-life case studies with deep-rooted philosophical endearment, looking  into the nature of pattern during birth. Her analysis of postures, locations, low and high walls as well as space for flexibility were instrumental when when beginning to think about a space designed for women and for birth.[Fig.14]39 Delivering a space for birthFOURER CONCEPT DRAWINGSDeeply influenced by her research and advice, I drew a series of concept modules that included all the available design-formulas which she sin-gle-handedly discussed in her articles.[Fig.15][Fig.16]40 Delivering a space for birthDECLINENorthern BC is facing a severe decline in maternity services, and they need our help.[Fig.17]41 Delivering a space for birthJUDE KORNELSENJude Kornelsen is a health-services researcher teaching out of UBC and co-director of the Centre for Rural Health Research. Through that outreach she publishes polemic texts on the outcomes of rural births, the distances women have to travel, specifically in Northern BC due to the regionalization of healthcare, and fights to promote for change and access when applicable. She is instrumental in invigorating my chapter of research regarding Northern Health care as she opened up the term of Evacuation Birth for me, something so common but also commonly unknown which primarily affects Indigenous women, mothers, families and communities due to the vast landscape and area of Northern BC.[Fig.18]42 Delivering a space for birthEVACUATION BIRTHEvacuation Births force mothers to travel on average 3,266 km (includes all pre-natal and post natal as well as the birth trip) to access maternity services in Northern BC, leaving the safety and comfort of their home at 36 weeks pregnant. This is a mandate the NHA have installed in order to have medical coverage for birth, at the closest available hospital.[Fig.19]43 Delivering a space for birthHEALTH AUTHORITIESBritish Columbia is split into 5 health regions, with the Northern Health Au-thority (NHA) located in purple.[Fig.20]44 Delivering a space for birthFNHAThe First Nations Health Authority has over 135 active health centres through-out BC. It is the first and only provinicial first nations health authority in Can-ada which works to transform and reform the way healthcare is delivered to BC first nations. A whole slew of opportunities and outreach online.[Fig.21][Fig.22]45 Delivering a space for birthLEVEL 3 HOSPITAL7 Level 3+ Hospitals are within the Northern Health Authority, those hospitals are rated to support c-sections and thus employ surgeons. Prince George has the highest rated hospital at UNBC with the only NICU in the North.[Fig.23][Fig.24]46 Delivering a space for birthLANGUAGE BORDERSThese lines do not indicate Indigenous territories but language borders across BC. You can see how the location of hospitals and roads don’t neces-sairly align with this outline.[Fig.25]47 Delivering a space for birthEVACUATION BIRTH ROUTESHere we come back to the evacuation birth, demonstrating the vast distanc-es that women must travel to access maternity services. This much travel is directly associated with adverse outcomes for newborns and mothers. The goal is to combat immeasurable travel times that woman face when evacuat-ed from their communities to give birth, often alone, self-funded, as well as all the psychosocial aspects and stresses this process adds. You can imagine at 36 weeks pregnant getting up and driving to a town that is completely foreign to you...[Fig.26]48 Delivering a space for birthNORTHERN BC MIDWIVESHere are the 18 currently employed midwives that work out of hospitals and health-centres across Northern BC. Two locations in particular, Niislaa Naay Midwifery Care centre in Old Massett, Haida Gwaii, and Skeena Midwives out of Hazelton, are governmentally funded midwife-led maternity services, meaning they do not have direct access to a surgeon. Thus these healthy examples promote that midwife-led maternity services are a viable option for aiding in healthcare for rural residents.[Fig.27]49 Delivering a space for birthINDIGENOUS TERRITORY MAPWhen we look at this vast map of all Indigenous communities in the North, and from conversing directly with healthcare practitioners and midwives who currently work in the North, the psychosocial traumas of the western medical system are rooted in negligence and racism. To design for these communi-ties would inherently bring forth further dialogues with local residents, but also the opportunity to look closely at the phenomenal buildings that were produced here originally...[Fig.28]50 Delivering a space for birthPLANK HOUSESThese are truly the first examples of a building vernacular that was rooted - both in material and form - in the Pacific Northwest. Planks from trees were harvested often by begging from the tree, which involved taking from the outer diameter and slowly moving inwards all while keeping the tree alive. This ethos of design is profound on so many spiritual, ritualistic and empa-thetic levels. [Fig.29]51 Delivering a space for birthDRAWINGSMy design process, which was always merging research and influence had to begin to take shape by processing my learnings as well as intense emotions and thoughts. Bringing back the earlier teachings by Foureur, the knowledge and comfort gained from our personal home-birth merged with elements that mask, shield, and give opportunities for change in current birth centres.[Fig.30][Fig.31]52 Delivering a space for birthH+H=BIRTHPODI had to rely on a solution that needed to be a harmonious version of all avail-able birth venues. Thus, linking the Hospital with the Home must equal the Birthpod.[Fig.32]53 Delivering a space for birthSHIPPINGIf we were to cover this much land, the only construction process that made feasible sense, due to limited construction labour & materials available in the North (which leads to inherently high costs to build there), were modular, pre-fabricated units that could be constructed in a factory to fit snuggly on a flat-bed semi-truck for shipping. The modular construction would make custom elements available due to the technical support while working in a factory, as well as making sure each building is identical, to aid in midwives who travel to be able to occupy and facilitate the space with ease and awareness.Constraining the form of the Birthpod to this size added a third and final de-sign aspect. The first being how to design for birth as a man, the second be-ing how to design for Indigenous communities as a non-Indigenous person, and thirdly how to adapt all of these prescriptions into a long rectangle. And it was really through talking, listening and learning that I was able to hopefully get close to continuing this dialogue through design.[Fig.33]54 Delivering a space for birthMAXIMUM SIZEI capped the birthpod at 55’ long to keep excess space for potential on-board water and waste barrels/management. These dimensions include exterior walls, flooring, and the maximum height of roof ridge.[Fig.34]55 Delivering a space for birth1 HR DRIVE  By placing 1 hour driving radius circles throughout the health region, I was able to confidently land on a count of 20 Birth Pods to be implemented to be accessible to nearly 90% of the listed communities. A total of 40 midwives would be needed to service them (2 midwives need to legally be at each birth in BC), this promotion engages in a rapid demand for leniency towards midwifery regulations in the North (currently only UBC offers this professional degree), and also encouraging Midwives from other health regions to move there for work, which is often the current case for employment.[Fig.35]56 Delivering a space for birth20 PODSFinancially speaking, 20 birth pods could equal the cost of 2.3 Vancouver Specials in the current housing market, which have asking prices of $1.5m each, the pods come in at $350sqft with a 500 sqft interior.[Fig.36]57 Delivering a space for birth58 Delivering a space for birthThe Birthpod floorplan, restrained to the 65’ long by 12’ wide flat bed truck which the building would be shipped atop of, brought forth design decisions that integrated expansion from the unit with minimal physical labour. This manifested in the form of moveable, kinetic walls and roofs that integrates industrial piano-hinge components to “flip down and out”, expanding the usable  and covered space. The new eave creates covered porches as well as periphery privacy when inside of the Birthpod.The following pages are stills from a stop motion animation film displaying a Birthpod being dropped off in a remote and rural location by a semi-truck on a prepared gravel site.“The Drop-off” 1:32mins, Stop Motion Animation, 2021[Fig.37]59 Delivering a space for birth60 Delivering a space for birth61 Delivering a space for birth62 Delivering a space for birth63 Delivering a space for birth64 Delivering a space for birth65 Delivering a space for birth66 Delivering a space for birth67 Delivering a space for birth68 Delivering a space for birth69 Delivering a space for birth70 Delivering a space for birth71 Delivering a space for birth“Delivering a Space for Birth”, 11:34 minsStop Motion Animation, 2021Puppets by Toby PikelinVoice by Britt IrvinMusic by Jaclyn Blumas aka Lord AukSound Design by Michelle IrvingAdditional Drawing by Meg Berry & Emma DurhamCamera Assistance by Michael IrvineThe following pages display a series of stills taken from the stop motion animation film which was presented on April 26th, 2021.https://vimeo.com/541331820[Fig.38]72 Delivering a space for birth73 Delivering a space for birth74 Delivering a space for birth75 Delivering a space for birth76 Delivering a space for birth77 Delivering a space for birth78 Delivering a space for birth79 Delivering a space for birth80 Delivering a space for birth81 Delivering a space for birth82 Delivering a space for birth83 Delivering a space for birth84 Delivering a space for birth85 Delivering a space for birth86 Delivering a space for birth87 Delivering a space for birth88 Delivering a space for birth89 Delivering a space for birth90 Delivering a space for birth91 Delivering a space for birth92 Delivering a space for birth93 Delivering a space for birth94 Delivering a space for birth95 Delivering a space for birth96 Delivering a space for birth97 Delivering a space for birth98 Delivering a space for birth99 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Delivering a space for birth162 Delivering a space for birth163 Delivering a space for birth164 Delivering a space for birth165 Delivering a space for birth166 Delivering a space for birth167 Delivering a space for birth168 Delivering a space for birth169 Delivering a space for birth170 Delivering a space for birth171 Delivering a space for birth172 Delivering a space for birthTHANK YOU FOR YOUR CONVERSATION & AIDBarbara Webster • RN, Clinical Nurse Specialist, Maternal Child Health, FNHABethany Nash • RM, Terrace, NHABecca Mlikotic • RM, Prince George, NHASomer Urquhart • RM, New Westminster, FHACarmen Wiebe • RM, Hazelton, NHACelina Laursen • RM, Haida Gwaii, NHACecilia Larson • Local Coordinator, Rural Surgical and Obstectrical Networks, HazeltonCathy Ellis • RM, Associate Professor of Teaching Lead, Midwifery Global Health, UBCChristina Tonella • Provincial Director, Perinatal Services BCGreg Johnson • Architect, BCHana Lang • RM, Hazelton, NHAInge Roecker • Architect, BCJim Hart • Artist, Haida GwaiiJoty Dhaliwal • Designer, SFJude Kornelsen • Centre for Rural Health Research, BCJulia-Anne Weaver • Evacuation Birther, ABKim Holden • Doula, Architect, NYCLisa Sutherland • RM, Midwifery Lead, Perinatal Services BCLucy Barney • Perinatal Services BC, FNHAPatrick Stewart • Nisga’a ArchitectPeter Vlahos • OKIB Director of HealthRaman Holat • Certified Holistic Birth & PP DoulaSandra Schloegel • Midwifery Office Manager, Prince George, NHAShannon Greenwood • RM, Haida Gwaii, NHAShellie Gleave • Eco Co-op Community Service Centre, Fraser Lake, NHAVanessa Salmons • Executive Lead, Perinatal Program, Northern HealthMy family & friends173 Delivering a space for birthBibliographyA Patchwork of Care: Midwifery in Canada, 2015. . 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